Reliability, validity and distribution of the Spanish female sexual function index in women with relapsing multiple sclerosis.

BACKGROUND: The Female Sexual Function Index (FSFI) is a widely recognized tool for assessing sexual dysfunction (SD). However, its validation for Spanish women suffering from multiple sclerosis (MS) has not yet been conducted. AIM: The study aimed to examine the psychometric properties of the 19-item Spanish version of the FSFI (svFSFI) in women with relapsing MS. METHOD: A total of 137 women with relapsing MS from three Spanish centers participated in the study and completed the svFSFI. The psychometric properties of the questionnaire were evaluated. The prevalence of SD in the study cohort was determined, and its association with clinical and sociodemographic variables was analyzed using bi- and multivariate regression analyses. RESULTS: The svFSFI demonstrated excellent test-retest reliability and substantial-to-excellent internal consistency in the context of relapsing MS. There was significant convergent validity in the intercorrelations of domains. Discriminant validity showed differences in SD between women with high and low neurological disability, as measured by the Expanded Disability Status Scale (EDSS) scores. An exploratory factor analysis indicated a five-factor structure for the svFSFI. The prevalence of SD in the MS cohort was found to be 42.6%, with the 'desire' and 'arousal' domains being the most affected. Factors such as EDSS score, fatigue, depression, and having a stable partner were found to influence the total svFSFI score. CONCLUSION: The study validates the svFSFI as a reliable and valid instrument for evaluating sexual dysfunction in Spanish women with MS.

Roundness variation in JPEG images affects the automated process of nuclear immunohistochemical quantification: correction with a linear regression model.

The volume of digital image (DI) storage continues to be an important problem in computer-assisted pathology. DI compression enables the size of files to be reduced but with the disadvantage of loss of quality. Previous results indicated that the efficiency of computer-assisted quantification of immunohistochemically stained cell nuclei may be significantly reduced when compressed DIs are used. This study attempts to show, with respect to immunohistochemically stained nuclei, which morphometric parameters may be altered by the different levels of JPEG compression, and the implications of these alterations for automated nuclear counts, and further, develops a method for correcting this discrepancy in the nuclear count. For this purpose, 47 DIs from different tissues were captured in uncompressed TIFF format and converted to 1:3, 1:23 and 1:46 compression JPEG images. Sixty-five positive objects were selected from these images, and six morphological parameters were measured and compared for each object in TIFF images and those of the different compression levels using a set of previously developed and tested macros. Roundness proved to be the only morphological parameter that was significantly affected by image compression. Factors to correct the discrepancy in the roundness estimate were derived from linear regression models for each compression level, thereby eliminating the statistically significant differences between measurements in the equivalent images. These correction factors were incorporated in the automated macros, where they reduced the nuclear quantification differences arising from image compression. Our results demonstrate that it is possible to carry out unbiased automated immunohistochemical nuclear quantification in compressed DIs with a methodology that could be easily incorporated in different systems of digital image analysis.

Appraisal of immune response in lymphoproliferative syndromes: a systematic review.

In lymphoproliferative syndromes, tumoural-immune cell interactions depend on a number of factors related to tumoural and immune cells. Recent gene expression data tend to confirm the decisive role of the reactive microenvironment in the development and clinical behaviour of lymphoproliferative syndromes, and encourage particular interest in the role of T cells and accessory cells. This systematic review brings together the accumulated knowledge about "immune signatures" in Hodgkin and non-Hodgkin lymphomas. Extracted results revealed that the presence of T lymphocytes, regulatory T cells and non-activated CTL in the reactive microenvironment appear commonly to be related with a favourable outcome in the majority of lymphoproliferative syndromes, whereas the presence of TAM, NK cells and activated CTLs appear more usually related with a poor prognosis. The direct involvement of these "immune signatures" in the histopathological morphology, classification, clinicobiological characteristics and outcome of affected patients stimulates the search for new and more appropriate immunotherapeutic strategies.

Effects of image compression on automatic count of immunohistochemically stained nuclei in digital images.

This study investigates the effects of digital image compression on automatic quantification of immunohistochemical nuclear markers. We examined 188 images with a previously validated computer-assisted analysis system. A first group was composed of 47 images captured in TIFF format, and other three contained the same images converted from TIFF to JPEG format with 3x, 23x and 46x compression. Counts of TIFF format images were compared with the other three groups. Overall, differences in the count of the images increased with the percentage of compression. Low-complexity images (< or =100 cells/field, without clusters or with small-area clusters) had small differences (<5 cells/field in 95-100% of cases) and high-complexity images showed substantial differences (<35-50 cells/field in 95-100% of cases). Compression does not compromise the accuracy of immunohistochemical nuclear marker counts obtained by computer-assisted analysis systems for digital images with low complexity and could be an efficient method for storing these images.

Quantification of diverse subcellular immunohistochemical markers with clinicobiological relevancies: validation of a new computer-assisted image analysis procedure.

Tissue microarray technology and immunohistochemical techniques have become a routine and indispensable tool for current anatomical pathology diagnosis. However, manual quantification by eye is relatively slow and subjective, and the use of digital image analysis software to extract information of immunostained specimens is an area of ongoing research, especially when the immunohistochemical signals have different localization in the cells (nuclear, membrane, cytoplasm). To minimize critical aspects of manual quantitative data acquisition, we generated semi-automated image-processing steps for the quantification of individual stained cells with immunohistochemical staining of different subcellular location. The precision of these macros was evaluated in 196 digital colour images of different Hodgkin lymphoma biopsies stained for different nuclear (Ki67, p53), cytoplasmic (TIA-1, CD68) and membrane markers (CD4, CD8, CD56, HLA-Dr). Semi-automated counts were compared to those obtained manually by three separate observers. Paired t-tests demonstrated significant differences between intra- and inter-observer measurements, with more substantial variability when the cellular density of the digital images was > 100 positive cells/image. Overall, variability was more pronounced for intra-observer than for inter-observer comparisons, especially for cytoplasmic and membrane staining patterns (P < 0.0001 and P = 0.050). The comparison between the semi-automated and manual microscopic measurement methods indicates significantly lower variability in the results yielded by the former method. Our semi-automated computerized method eliminates the major causes of observer variability and may be considered a valid alternative to manual microscopic quantification for diagnostic, prognostic and therapeutic purposes.

Tumor-infiltrated immune response correlates with alterations in the apoptotic and cell cycle pathways in Hodgkin and Reed-Sternberg cells.

PURPOSE: To analyze tumor-microenvironment relationships in Hodgkin lymphoma (HL) as potential determinants in the decision-making process related to the alterations in cell cycle and apoptotic pathways of Hodgkin/Reed-Sternberg (H/RS) cells. EXPERIMENTAL DESIGN: Based on a cohort of 257 classic HL patients, we carried out a global descriptive correlational analysis and logistic regression study to identify tumor-infiltrated immune cell rate in HL that could be interconnected with genes involved in the regulation of apoptotic/proliferative pathways in H/RS cells. RESULTS: Our results reveal the existence of a connection between the reactive microenvironment and molecular changes in apoptotic/proliferative pathways in H/RS cells. A lesser incidence of infiltrated cytotoxic cells in the tumor (CD8(+) T lymphocytes, CD57(+) natural killer, and granzyme B(+) cells) was associated with overexpression of antiapoptotic proteins (Bcl-X(L), survivin, caspase-3, and nuclear factor-kappaB) in tumoral cells. Increased incidence of general infiltrated immune cells, such as CD4(+) T lymphocytes, CD57(+) natural killer cells, activated CTL, and dendritic cells, in the microenvironment of the tumor was associated with increased growth fraction of tumoral cells, including G(1)-S checkpoint (cyclin D and cyclin E) and tumor suppressor pathways (p16 and SKP2), and with the presence of EBV (signal transducers and activators of transcription 1 and 3 expression; STAT1/STAT3). CONCLUSIONS: A lower level of cytotoxic cells correlated with an increase of antiapoptotic mechanisms in H/RS cells, whereas the global infiltrated immune population correlated with the growth fraction of the tumor. Our collective data suggest a causal relationship between infiltrated immune response and concurrent changes of the different proliferative checkpoints, tumor suppressor, and apoptotic pathways of H/RS cells in HL.

Automated quantification of nuclear immunohistochemical markers with different complexity.

Manual quantification of immunohistochemically stained nuclear markers is still laborious and subjective and the use of computerized systems for digital image analysis have not yet resolved the problems of nuclear clustering. In this study, we designed a new automatic procedure for quantifying various immunohistochemical nuclear markers with variable clustering complexity. This procedure consisted of two combined macros. The first, developed with a commercial software, enabled the analysis of the digital images using color and morphological segmentation including a masking process. All information extracted with this first macro was automatically exported to an Excel datasheet, where a second macro composed of four different algorithms analyzed all the information and calculated the definitive number of positive nuclei for each image. One hundred and eighteen images with different levels of clustering complexity was analyzed and compared with the manual quantification obtained by a trained observer. Statistical analysis indicated a great reliability (intra-class correlation coefficient > 0.950) and no significant differences between the two methods. Bland-Altman plot and Kaplan-Meier curves indicated that the results of both methods were concordant around 90% of analyzed images. In conclusion, this new automated procedure is an objective, faster and reproducible method that has an excellent level of accuracy, even with digital images with a high complexity.

Adaptación para adolescentes de la versión española del NEO PI-R(JS NEO) / Junior version of the Spanish NEO PI-R (JS NEO)

Este artículo presenta los primeros datos del desarrollo de la versión española para adolescentes, entre 12 y 17 años, del NEO PI-R (JS NEO). Noventa y dos de los 240 ítems fueron modificados con el fin de adaptar el vocabulario de los mismos a este grupo de edad. Las propiedades psicométricas del JS NEO han sido investigadas en una muestra de 2.505 adolescentes. Los resultados muestran cómo la estructura factorial encontrada con el NEO PI-R para adultos se replica en la versión junior. Las fiabilidades de consistencia interna y estabilidad temporal de las escalas fueron adecuadas en la mayor parte de los casos. Además, la correlación entre las escalas de las versiones para adultos (NEO PI-R) y adolescentes (JS NEO) muestran que la versión para adolescentes presenta una validez de constructo adecuada

This article presents the preliminary data of the development of a Junior version of the Spanish NEO PI-R (JS NEO), suitable for teenagers from 12 to 17 years of age. From the 240 original English items, 92 were modified or reworded to some degree to make the vocabulary adequate for this age group. The psychometric properties of the JS NEO were investigated in a sample of 2,505 adolescents. Results showed that the adult NEO PI-R factor structure was replicated in the junior version of the inventory. Internal consistency and temporal stability reliabilities of the scales were adequate for most scales. Furthermore, the cross-form correlations between the junior (JS NEO) and the adult (NEO PI-R) scales indicated satisfactory construct validity of the junior version of the inventory

[Junior version of the Spanish NEO PI-R (JS NEO)]. / Adaptación para adolescentes de la versión española del NEO PI-R(JS NEO).

This article presents the preliminary data of the development of a Junior version of the Spanish NEO PI-R (JS NEO), suitable for teenagers from 12 to 17 years of age. From the 240 original English items, 92 were modified or reworded to some degree to make the vocabulary adequate for this age group. The psychometric properties of the JS NEO were investigated in a sample of 2,505 adolescents. Results showed that the adult NEO PI-R factor structure was replicated in the junior version of the inventory. Internal consistency and temporal stability reliabilities of the scales were adequate for most scales. Furthermore, the cross-form correlations between the junior (JS NEO) and the adult (NEO PI-R) scales indicated satisfactory construct validity of the junior version of the inventory.